Author/Editor		Fokter, Samo K; Vengust, Vilibald
Title		Masivna ekstruzija medvretenčnega diska - spondilodeza da ali ne
Translated title		Massive disc herniation: to fuse or not to fuse
Type		članek
Source		In: Komadina R, Stahovnik A, editors. 5. Celjski dnevi. Zbornik izbranih predavanj simpozija o poškodbah in okvarah hrbtenice; 2005 apr 8-9; Celje. Celje: Splošna bolnišnica Celje,
Publication year		2005
Volume		str. 186-92
Language		slo
Abstract		Introduction: This retrospective study analyzed the results of treatment in patients with massive lumbar disc extrusions at L4 - L5 level treated surgically with two different procedures. The goal was to determine whether the additional fusion improves the clinical outcome in patients undergoing decompressive laminotomy. Methods: Eight patients who had first symptomatic acute massive disc herniation underwent herniotomy, posterior decompression as necessary, and fusion (Group A), while 6 patients were treated without fusion (Group 8). At final follow-up of 6 years (mean, range 2 to 8 years) the patients were asked to estimate their low back and leg pain as well as their activity level and satisfaction on a visual scale, and to fill-in the Oswestry questionnaire. Clinical and radiological evaluation was performed using modified scoring system of the Japanese Orthopaedic Association (JOA) and score after Tria. Overall clinical results were assessed using the modified Stauffer-Coventry's evaluating criteria. Results: Patients in Group A were doing better than those in Group B according to low back pain, leg pain, activity level, patient satisfaction, Oswestry questionnaire, and scores of Tria and JOA. Seven patients of Group A and 2 patients in Group B achieved an overall satisfactory (good or excellent) result. Conclusion: Despite the groups were small for statistical analysis, the results of this study suggest that patients undergoing decompression for massive disc herniation at L4-L5 level may do better if being fused at the time of primary procedure.
Descriptors		INTERVERTEBRAL DISK DISPLACEMENT LOW BACK PAIN SPINAL FUSION TREATMENT OUTCOME